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Colorectal cancer: Not just your parent's disease

March 28, 2016 | Patricia Harriman
David Baranowski and Dr. Jason Zell

David Baranowski and Dr. Jason Zell.


Colorectal cancer is experiencing a youth movement in the U.S. While it’s true that more than 90 percent of colorectal cancer cases occur in people aged 50 and older, incidence rates have been declining in this age group, thanks to improvements in screening.

However, colorectal cancer is on the rise among young adults.

A study by UCI Health oncologist Dr. Jason Zell analyzed more than 231,500 colorectal cancer cases reported in the California Cancer Registry over a 22-year period and found significant increases in colorectal cancer incidence among the 20-29 and 30-39 year-old age groups.

According to the National Cancer Institute, since 2001, there has been an average annual increase of 2.1 percent in colorectal cancer in those under age 50.

Think you’re too young for colorectal cancer?

When he was 26 years old, training for a marathon and engaged to be married, David Baranowski found out a month before his wedding that he had Stage IIA colon cancer.

He had begun experiencing stomach pains, and over the next several months, went through a series of gastrointestinal tests. No ulcers were found, but it was discovered that he had anemia. Puzzled by this finding, Baranowski’s doctor ordered a colonoscopy as a last resort.

That’s when UCI Health colorectal surgeon Dr. Michael Stamos detected cancer. The Tuesday after his Saturday wedding in August of 2014, Stamos performed a colectomy, removing a tumor from the right side of Baranowski’s colon.

Baranowski also had six months of chemotherapy under the supervision of Zell, who he continues to see every six months. Since his treatment, Baranowski has shown no signs of recurrence.

Why colon cancer targets the young

Possible explanations for the concerning increase in colorectal cancer incidence among young adults include:

  • Lack of cancer screening.
  • Delayed diagnosis due to lack of insurance.
  • Low index of suspicion from physicians.
  • Higher prevalence of predisposing risk factors.
  • Dietary and lifestyle factors may also play a part. Such things as intake of fats, red meats, fruits and vegetables, along with physical activity and obesity, have also been shown to increase colorectal cancer risk.

“While the overall risk of colorectal cancer in young adults is low, this is the only group with rising incidence rates, and more research is needed to understand the process before we can appropriately implement strategies for screening this historically low-risk population,” Zell says.

Colorectal cancer symptoms

This trend highlights the need for increased awareness by patients and physicians on the warning signs of colorectal cancer and when further screening is needed.

Common symptoms include:

“A significant number of patients – approaching 10 percent – like David, don’t even have the risk factor of being over age 50,” Stamos says. “When symptoms develop, even in a ‘low risk’ patient, a thorough investigation is warranted. Colorectal cancer is very common, it is very preventable, and even when not prevented, it is very curable."

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